Traumatic Injuries to Dentition Flashcards

Ellis Classification (1940): Oldest classification for traumatic dental injuries, mainly referenced by physicians.
Ellis Class I: Fracture confined to enamel.
Ellis Class II: Fracture involving enamel and dentin.
Ellis Class III: Fracture that includes pulp involvement.
Ellis Class IV: Fracture affecting the root structure.
WHO Classification: Comprehensive and widely accepted internationally; broader than Ellis but complex for daily use.
Modified WHO Classification (Andreasen 1981): Comprehensive categorization of luxation injuries and dental tissue injuries.

Injuries to Supporting Bone: Includes comminution and fractures of alveolar bone and jaw.
Injuries to Gingiva or Oral Mucosa: Involves contusions, abrasions, and lacerations—lacerations may require suturing.
Luxation Injuries: Categories include concussion, subluxation, extrusive, lateral, intrusive luxation, and avulsion.

Injuries to Hard Dental Tissue: Enamel infarction, uncomplicated (Ellis Class II) and complicated crown fractures, crown-root fractures, and root fractures.

Traumatic Dental Injuries: Affect approximately 25-30% of adults in the USA; lower incidence in children (1-3%).
Age Vulnerability: Most prevalent in ages 8-12 years; rare after 30; common in 16-30 during leisure or alcohol-related activities.
Common Types of Oral Injuries: Predominantly dental injuries (92%); fractures of enamel/dentin without pulp involvement are most frequent.

Etiological Factors: Include falls, fights, sports, accidents, epilepsy, Battered Syndrome, and malocclusion (overjet risk).
Pulp Vitality Prediction: Injury type affects survival; teeth with immature apices have better chances of regaining vitality post-trauma.

SOAP Protocol: Documentation framework including subjective complaints, objective examination, assessment, and treatment planning.
Pulp Vitality Testing: Requires cautious interpretation; false negatives common initially; true vitality responses can be delayed.
Follow-Up Examination: Essential for monitoring outcomes over an extended period; various recalls recommended based on timing after injury.

Common Sequelae: Pulp necrosis, canal obliteration, and external root resorption (less responsiveness to tests).
Concussion: Mild injury with high pulp survival rates; no displacement of the tooth.
Subluxation: Abnormal mobility without displacement; high chances of pulp survival for both open and closed apices.
Luxation Types:
- Extrusive luxation involves partial displacement; survival varies with apex maturity.
- Lateral luxation causes directional displacement and socket fracture; survival prognosis decreases with closed apices.
- Intrusive luxation results in tooth displacement into bone, severely affecting pulp survival.
- Avulsion denotes complete tooth displacement; survival chances are minimal with prolonged time out of socket but improve with immediate reimplantation.